Serum triiodothyronine values. Prognostic indicators of acute mortality due to Pneumocystis carinii pneumonia associated with the acquired immunodeficiency syndrome.
A feasibility study was undertaken prospectively to identify early clinical and laboratory factors predictive of acute hospital mortality in patients with the acquired immunodeficiency syndrome and concurrent Pneumocystis carinii pneumonia. Twenty-six patients hospitalized with bronchoscopy-proved P carinii pneumonia were studied. Nineteen patients survived their episode of P carinii pneumonia, while 7 subjects did not. The only clinical factor associated with mortality was a history of a shorter duration of pulmonary symptoms. Univariate analysis showed decreased total CD8 cell count, total lymphocyte count, serum hemoglobin, serum albumin, total thyroxine, and total triiodothyronine values consistent with a poor outcome. Multivariate logistic regression analysis showed that the single best prognostic indicator of acute mortality appeared to be a total serum triiodothyronine value less than 0.70 nmol/L obtained early in the hospital course, and that the combination of serum triiodothyronine and hemoglobin values provided a better indication for survival. These preliminary observations would appear to justify the further exploration of serial serum triiodothyronine measurements as a potentially valuable prognostic indicator for the treatment of patients with acquired immunodeficiency syndrome infected with P carinii and possibly other intercurrent infectious illnesses.
Fried
J C
JC
Section of Pulmonary/Critical Care Medicine, University of Southern California School of Medicine, Los Angeles 90033.
LoPresti
J S
JS
Micon
M
M
Bauer
M
M
Tuchschmidt
J A
JA
Nicoloff
J T
JT
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D005240:Feasibility Studies; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008231:Lymphopenia / Q000097:blood; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011020:Pneumonia, Pneumocystis / Q000097:blood* / Q000000981:diagnostic imaging / Q000401:mortality; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011859:Radiography; D012709:Serum Albumin / Q000378:metabolism; D013963:Thyroid Hormones / Q000097:blood; D014284:Triiodothyronine / Q000097:blood*
D006454:Hemoglobins; D012709:Serum Albumin; D013963:Thyroid Hormones; D014284:Triiodothyronine; D007770:L-Lactate Dehydrogenase; D010100:Oxygen